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At a glance

Genetically transmitted polymalformative syndrome characterized by cataract, mental retardation, anal atresia, and urinary defects.


Cataract Mental Retardation Anal Atresia Urinary Defects Syndrome.


The incidence is unknown.

Genetic inheritance

Autosomal recessive inheritance trait.

Clinical aspects

Some degree of mental retardation is usually present. Ocular abnormalities include nystagmus, ocular muscle paresis, and cataracts. Imperforate anus is common. Tetralogy of Fallot may be present. No information is available regarding other forms of congenital heart disease. The palate may be high and narrow. Genitourinary abnormalities include ectopic testes and hypospadias.

Anesthetic considerations

Considerations are determined by the presence of congenital heart disease. The most frequent malformation is tetralogy of Fallot in particular. The degree of palliation/correction, current myocardial function, and medications must be assessed. An abnormally shaped palate could affect ease of intubation. Patient cooperation may be limited secondary to mental retardation. Sedative and/or anxiolytic premedication and presence of the primary caregiver for induction of anesthesia may be helpful.

Pharmacological implications

Subacute bacterial endocarditis prophylaxis may be indicated.


Karandikar  S, Maria  D, Kamble  B: Congenital cataract with multiple congenital anomalies in a sibship. Indian J Ophthalmol 27:59, 1979.  [PubMed: 541035]

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